A guilt-free lunch

This is the dilemmma:
You are on call and have three patients waiting in A&E, all in considerable pain, one of them bleeding from the rectum, but none so sick as to be in danger of death. The A&E nurses are pressuring you to see the patients before they 'breach' the all-important 4 hour mark. However, you've just been on the ward sorting out a patient in heart failure, and that has taken the best part of an hour. Your bleep goes off - it is the ward nurses bleeping you about yet another patient - he has fallen over in the shower and hit his head on a hand rail, but seems fine apart from a large bruise. And here's the crunch - it's lunch time. If you've any medical experience you'll realise that the situation as described is perfect to take a break in - no lasting harm will be done if no action is taken within the next 10 minutes. What I have also learnt (from bitter experience), is that you have to grab these opportunities when they come, or you might not have the luxury of anything to eat (or drink) for the next 10 hours. (see 2 entries down)

So you take a break for lunch. But it is a furtive, hurried break. Even if the hospital canteen food had been tastier, you'd still end up choking it down. How can you sit down and relax, even for 5 minutes, when you know you've left people who need attention? And that's assuming your bleep doesn't go off (it inevitably does - I've never so much as eaten a sandwich without it sounding before I've swallowed the first mouthful). I feel so guilty about taking a break for lunch that I have to lie to patients that I am going to see another patient who is sicker. I guess there is a grain of truth in it.

my first death certificate, or a minute's silence for Mrs. B

my first thought was that my stethoscope must be broken - it took a second to remember that i'd been called by the nurses to confirm her death. Mrs. B had breathed her last, and as i peeled back her eyelids in turn, large inanimate pupils met my torch beam.

She had been tucked into bed and a crepe bandage wound round her head to hold her jaw shut. Under the dim reading light, the regulation pink hospital nightdress cast a rosy glow on her gaunt cheeks. A black and white photograph of her husband continued its vigil over her from the tray table. They must have been a handsome couple.

Mrs. B was 70, and had an advanced bladder cancer that had eaten into her vagina - she had bloody, fungating metastases - and blocked off her kidneys, causing them to fail. But as horrible as her disease was, I reckon she had died well. Early on, it was decided that she should have radiotherapy to keep the symptoms at bay, and stents put in to help the kidneys drain. She had a long line put in her arm so she didn't have to endure daily needlesticks for blood tests or medication. When it became apparent that her kidneys were failing despite all the treatment, a 'do not resuscitate' order was discussed while she was still lucid. She looked comfortable until the last, and was alert apart from her final 2 days, during which she drifted into a deepening sleep.